In order to be able to perform examinations of the lower abdomen in a specific manner, medical examination apparatuses, such as a biopsy apparatus or local transmit and/or receive apparatuses, for example ultrasound heads or a local coil for magnetic resonance applications, are inserted rectally or vaginally into the lower abdomen of a patient to be examined, in order to be positioned as close as possible to the organ to be examined, e.g. the prostate, the ovaries, the rectum/bowel or the uterus.
An endorectal or endovaginal biopsy apparatus is used to take tissue samples from the organ to be examined, which are then examined for possibly cancerous substances. It is advantageous here to know the site from which the tissue was taken precisely, for example in order to be able to apply any necessary therapy in a specific manner. To this end the biopsy is monitored using medical imaging technology.
The medical imaging technology primarily known for such monitoring is sonography but sectional image methods such as computed tomography (CT) or magnetic resonance tomography, in some instances combined with functional Positron Emission Tomography (PET), are increasingly used. MRT in particular offers particularly good soft tissue contrast resolution as far as the latter methods are concerned.
To monitor the biopsy using such a sectional image method the patient is conveyed on a patient support table into the generally tunnel-type examination region of the corresponding medical device, with the endorectal or endovaginal examination apparatus already positioned in the lower abdomen.
Further examinations of the lower abdomen can also be performed with local transmit and/or receive apparatuses. Special local coils, endorectal or endovaginal coils are known in particular for magnetic resonance applications, which can be used to take particularly high-resolution recordings of the lower abdomen and which can also be used for magnetic resonance spectroscopy. To this end the local coils are inserted into the lower abdomen and the patient is introduced into a magnetic resonance device on a patient table.
To make the rectum more accessible, the patient is supported on his/her front (prone) on a respective patient support table and introduced thus into the respective examination space both for the biopsies described above, which are monitored using medical sectional image methods, and for examinations with the above-mentioned special local coils. However this position is not very comfortable for the patient. More protracted procedures, such as a prostate biopsy with up to 2 hours examination time, cannot be tolerated for longer periods by elderly patients in particular and the patient starts to feel ill at ease, agitated or even short of breath. As well as the lack of comfort for the patient, it may also result in patient movement and therefore unwanted motion artifacts in the images.
At the conference of the “International Society for Magnetic Resonance in Medicine”, ISMRM 2006, in Seattle, Wash., USA a two-part apparatus was disclosed, which allows a patient to be supported on his/her back (supine) on the patient support table for am MR-monitored biopsy (Abstract “MRI-guided prostate biopsy in two different standard 1.5 T scanners using an endorectal biopsy device”, Proc. Intl. Soc. Mag. Reson. Med. 14 (2006), page 1446; and associated poster). However the patient must still slide into the patient tunnel feet first on the patient support table until an assistant standing behind the magnet of the magnetic resonance device can grasp and hold up the patient's legs. The helper then inserts a support part arranged at this end of the magnetic resonance device and connects it to the patient support table. A support system made up of two separate parts (patient support table and support part) is thus formed. The patient's legs are positioned on the support part so that an endorectal examination apparatus can be inserted. This procedure requires effort from both the assistant and the patient. More effort is required, the heavier the patient's legs are and depending on how much the patient can or must help the assistant in the process. The support part proposed at ISMRM 2006, which is introduced from the rear into the magnetic resonance device, can only be moved to a certain degree into the magnetic resonance device. In particular it is not possible to convey the patient support table and therefore the patient out of the magnetic resonance device after the examination without removing the support part again first. This extends the examination period.